Year 2. August 14. Leading in Our Clinical Mission.
By sjmartinez • August 14, 2023
The Department of Medicine Professional Group (DMPG) represents more than 1000 clinical faculty within the UCLA Department of Medicine (DoM). Their governance structure has been highly effective, and many initiatives have been spearheaded by the DMPG to support our clinical mission. I believe it is worthwhile to share some of these with the broader department.
DMPG Welcomes Incoming President and Board Members
The DMPG Executive Board advises the executive chair of the DoM on issues related to clinical practice. Josh Khalili, MD, was elected president of the DMPG Executive Board at the July meeting. Dr. Khalili practices primary care and extensivist medicine with a special interest in LGBTQ+ health in Santa Monica and at the CARE Center in Beverly Hills. Grace Chen, MD, clinical chief of the division of geriatrics, was elected vice-president. She practices in Westwood and at the Santa Monica-UCLA Hospital. Michelle Hwang, MD, was elected secretary. Dr. Hwang is a nephrologist who practices in Torrance. In addition to Dr. Hwang, new members include Daniel Puneky, MD (East Campus), Behi Rabbani, MD (South Campus), and Arielle Sommer, MD(Westwood).
Dr. Khalili will chair the annual meeting of the DMPG on Thursday, October 5th, which will include presentations by the leadership of UCLA Health. As he steps into this leadership role, Dr. Khalili shares:
”I am very grateful and excited to assume the role of DMPG President this year- I look forward to representing our faculty and ensuring that all voices are heard as we strive to continue improving our wellbeing and dedication to our patients and community.”
If you have not yet registered for the DMPG Annual Meeting, please do so here:
As DMPG looks forward to a new year of advancing best-in-class clinical care, while supporting and advocating for faculty, I extend gratitude to outgoing President Igor Kagan, MDfor his leadership over the successful 2022-2023 year. Igor shares a few reflections from his tenure:
"It was an honor to serve as the DMPG President this past academic year and to represent the interests of my colleagues. Thank you to everyone who had reached out to me during the year to share your concerns and suggestions. With the help of the entire DMPG Executive Board and Dr Abel we were able to focus on physician wellbeing. I am proud of our effort to implement Wellness Days and CME time among other initiatives."
This week the DMPG launched the 2023 – 2024 onboarding session to welcome the newest members of the team to launch a curriculum geared towards ensuring their success as they launch their clinical practice. I am pleased to share remarks about the onboarding program from Janet Pregler, MD who gave me a few highlights from the event:
“New DMPG faculty began the onboarding process on Wednesday, August 9th at Luskin Conference Center on UCLA’s Westwood Campus. Since 2015, clinical faculty who provide ambulatory care have met with departmental and UCLA Health leaders for orientation in a year-long program. Onboarding educates faculty on policies, procedures and organizational structures of UCLA Health, the UCLA Faculty Practice Group, the David Geffen School of Medicine, and the UCLA Department of Medicine.
Physician wellness and equity, diversity and inclusion are foundational to the curriculum, which includes large group instruction and small group sessions with regional medical directors and practice leads, educators and EDI champions, and communication skill training. Each division provides specialty specific instruction on clinical efficiency. Onboarding physicians are all assigned a practice partner from their specialty and region to answer practical clinical questions.
This year, 83 faculty from 12 divisions and 27 clinical sites will participate in onboarding. Representative faculty feedback about the onboarding experience includes:
“[I learned] how to be more efficient in CareConnect and use less clicks!”
“[I valued the] helpful explanation of our complicated pay structure.”
“[I appreciated] guidance on how to interact with staff so everyone feels involved and important.” (On physician wellness) “I wish I heard this talk 40 years ago.”
“Best part of the day was meeting all my new colleagues.”
“I am proud to be at an institution that prioritizes teaching of EDI.”
Program Representative Joash Wampande and DMPG Program Coordinator Alex Radilalehcollaborate with the faculty members of the DoM Professional Education Committee Drs. Janet Pregler, Behi Rabbani, and Arielle Sommer to design, present, and evaluate the onboarding program.
If you are interested in learning more or viewing previously recorded sessions, please see the DoM Onboarding Intranet Website (you may need to access it on a UCLA computer).”
Earlier this month, I had the pleasure of joining our new cohort of chief residents for lunch to learn about how they are settling into their new roles as well as their goals for the upcoming academic year. I enjoyed learning about their professional aspirations, their ideas for enhancing the quality of our training programs, publishing the proceedings of the residency report, and encouraging greater engagement with our distinguished faculty. The group brings tremendous energy to the role. They carry a strong degree of passion for ensuring that all trainees are supported while undergoing their rigorous training. I would like to share a few words from the current chiefs:
Dr. Abel (center) with 2023-2024 chief residents.
"Your Internal Medicine chief residents, the PEEPs, are dedicated to uplifting and guiding our residents through the positive pressures of training. Together we strive to advance medical education by fostering a comprehensive and innovative learning experience that equips residents with the knowledge and skills they need to excel in their careers. Concurrently, we seek to forge meaningful connections between experienced mentors and residents, forming a support network where wisdom and feedback are shared, and the personal and professional growth of each individual is prioritized. Looking ahead, we are wholeheartedly committed to recruitment endeavors that bring together ever more diverse and skilled trainees. We aspire to become the exemplar program for advancing diversity, equity, and inclusion in the context of scientific excellence, outstanding scholarship, and compassionate person-centered care. While pursuing excellence, we also aim to build a fun and vibrant atmosphere that promotes creativity, camaraderie, and a shared sense of purpose to sustain our residents during training and beyond. Through these interconnected goals, we hope to continue evolving our program into the place where education, mentorship, recruitment, and community optimally converge to shape a bright and rewarding future for our residents."
Yours Truly,
Wow. After reading that statement, a part of me wished that I could be a resident here under their watch. But then, the other part of my brain reminded me that you can only be a medicine resident once!
Karen Keniston, MD Awarded a 2023 Building Trust Through DEI Grant from the Alliance for Academic Internal Medicine
Congratulations to Karen Keniston, MD, who was awarded a Building Trust through Diversity, Health Care Equity, & Inclusion in Internal Medicine Training Grant from the Alliance for Academic Internal Medicine. She joins 19 internal medicine trainees from across the country who will use this support to fund an inter-personal project focused on improving trust and health equity in medicine. Dr. Keniston shares the following about her project which is a collaboration with the UCLA-Saban/Silver Lake Community Church Clinic:
Karen Keniston, MD
“The UCLA-Saban/Silver Lake Community Church (SLCC) Clinic is a project based on a collaborative partnership between multiple community-based programs and an interdisciplinary healthcare team. The goal is to provide equitable, high-quality care to patients experiencing homelessness by combining an established clinic and street medicine approach. The project also involves an educational component as an integrated continuity clinic in the Health Equity and Advocacy Pathway of the UCLA Internal Medicine Residency Program, with the goal of training residents on the fundamentals of community-based street medicine. It aims to ultimately advance health equity through teaching to provide excellent, equitable patient care.
The project launched in February 2022 with the integration of medical services into a community-operated food pantry. The SLCC food pantry has existed since 2008, and in 2019 partnered with SELAH Neighborhood Homeless Coalition to provide hot meals and clothing to people experiencing homelessness. As a SLCC food pantry volunteer, Dr. Hijab Zubairi recognized the limited healthcare resources for the neighborhood’s large, unhoused population and in partnership with SLCC and SELAH sought to provide medical services to this community as one aspect of larger on-site services. As part of the UCLA Health Equity and Advocacy Pathway, I participated in the project alongside Dr. Zubairi to provide patient care and to develop this project.”
Dr. Keniston adds:
“Working on this project and participating in the Health Equity and Advocacy Pathway of our program have truly been some of the most meaningful components of my time in residency. I’ve learned an incredible amount from Dr. Zubairi, who is so passionate about health equity and had the vision to create this clinic. Receiving this award is such an honor and ultimately leads us to be able to expand our scope and provide increasingly high-quality and comprehensive care to our patients.”
Well done Karen. We are inspired by your vision for and commitment to caring for the under-served.
UCLA Leadership in Dementia Care Pays off at the National Level
On July 31, 2023, CMS/CMMI announced the new Guiding an Improved Dementia Experience (GUIDE) Model that aims to:
Improve the quality of life for people living with dementia
Reduce burden and strain on unpaid caregivers of people living with dementia
Prevent or delay long-term nursing home care
These aims will be accomplished by a standardized set of services, including a person-centered care plan, care coordination, and caregiver services provided by a trained interdisciplinary team, including a care navigator. Payment will include a per-beneficiary-per-month payment and a respite care payment. This is the first time Medicare has ever paid for services aimed at caregivers.
Dr. David Reuben, chief of geriatrics, shares the following thoughts about the announcement:
“The content of the announcement was familiar. Many of the principles of the GUIDE model had been developed in the UCLA Alzheimer’s and Dementia Care Program and much of the evidence needed to justify this payment model was based on the UCLA Program. At UCLA, the Alzheimer’s and Dementia Care Program was a group effort, including our interdisciplinary team, community partners, philanthropists, the Department of Medicine, and UCLA Health. It has been a 12-year effort, creating the model and evaluating its benefits on quality, patients and caregiver clinical outcomes, health-care utilization and costs, and partnering-physician satisfaction.
As the story was unfolding, we worked with partners, including the Alzheimer’s Association, the American Geriatrics Society, the Gerontological Advanced Practices Nurses Association to disseminate the model nationwide and advocate for payment reform so that these services would be a Medicare-covered benefit.
Although the process was very long with several false starts, Medicare officials, particularly those at CMMI; members of Congress; and other Federal agencies listened and were supportive. Many had personal experiences as caregivers of relatives who lived with dementia. They knew that the currently available care was not enough.
Throughout the announcement, I wept tears of joy, not for me but for the millions of Americans with dementia and their caregivers who will receive the kind of dementia care we would want for our families and ourselves”.
Thank you David for your leadership and advocacy for some of the most vulnerable in our community.
Gregory Brent, MD Awarded a Senior Clinician Scientist Investigator (SCSI) Award from the VA
Please join me in congratulating Dr. Gregory Brent who is the recipient of a SCSI Award from the Department of Veterans Affairs (VA). This award recognizes outstanding physician scientists who are leading research at the VA, in addition to providing high-quality care to our veterans. The award provides additional funding for Dr. Brent’s BLRD Merit Award which supports the following project as described by Dr. Brent:
“Our VA-supported research, which I conduct in collaboration with my colleague Dr. Kaitlyn Yan-Yun Liu, focuses on the fundamental mechanisms of thyroid hormone signaling in neuronal growth and differentiation, applied to neuronal recovery in cellular models of hypoxia and rodent models of brain injury. Thyroid hormone is essential for neuronal and glial cell growth and differentiation in brain development. Activation of these pathways in the adult, with thyroid hormone and brain-selective analogs, show promise to reduce the impact of injury and promote recovery of brain function.”
Dr. Brent also shared the following reflection about the award:
“The opportunity to have 8 years of research support is rare and provides the freedom to pursue the most promising and potentially impactful research, even if it may take a longer time to develop, as well as providing stable support for a research team. I am very grateful to our VA GLA Research Service, led by Dr. Michael Ong, and the national VA Research and Development program that provides grant mechanisms to encourage and support clinician scientists at all career stages and in all disciplines to conduct research, while teaching trainees and providing clinical care to our veterans.“
Way to go, Greg!
Each week, DoM faculty are invited to speak with local and national media about many of the most pressing medical and public health challenges faced around the world. I am pleased to highlight some of these interviews in our new “In the News Section.” Check back each week and hear how our faculty are raising awareness about their research to our local and national community and the significant impact of these efforts in society and the world.
A person's home and neighborhood environment may play a major role in cardiovascular disease risk due to a wide range of factors affecting health behaviors, attitudes and resources.
Medicare could shell out more than $100,000 a year per patient to cover the drug and the complex scans and tests needed to monitor its potentially lethal risks for patients.
One of the core values of our emerging strategic plan is Leadership. I hope the content of this note, demonstrates that we will be building on an already strong foundation.
Dale
P.S.
My mom has been in town the past couple weeks. She walks daily at least three miles, and on weekends gets me up early to join her in a walk/run. Here are two pictures from this weekend’s 5-mile walk/run. She walks, we walk together and talk and then she sends me off to get some running in ahead of her and to backtrack to re-join her. What is remarkable is her pace. When I run ahead say for a mile and turn back she is already more than ¾ of the way from where we left off. The pictures below are from the beginning and at the 2.5-mile point of our Sunday outing. This is in the hills, so it was not only distance but some elevation gains as well, as you can see in the second picture.
Budoff MJ. When Is Enough Enough? Additional Evidence of the Power of Zero. Circ Cardiovasc Imaging. 2024 Dec 20:e017714. doi: 10.1161/CIRCIMAGING.124.017714. Epub ahead of print.[...]
Punnanithinont N, Kambalapalli S, Iskander B, Ichikawa K, Krishnan S, Lakshmanan S, Roy SK, Budoff M. "Anti-inflammatory Therapies in Atherosclerosis - Where are we going?".[...]
